How much does health insurance cost?

BeWellnm for Small Business is designed to offer affordable coverage. Small businesses may choose from four levels of coverage and decide how much to contribute toward employees’ premiums. The cost to the business will depend on the metal level chosen and the amount paid toward premiums.

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BeWellnm for Small Business is designed to offer affordable coverage. Small businesses may choose from four levels of coverage and decide how much to contribute toward employees’ premiums. The cost to the business will depend on the metal level chosen and the amount paid toward premiums.

A tax credit lowers the amount of tax you pay. Employers with fewer than 25 employees may be eligible for a tax credit for a portion of their contribution to employee premiums. The maximum credit for small businesses is 50% of the amount paid toward employees’ premiums. The maximum credit for nonprofit employers is 35%. Small business tax credits are only available when coverage is purchased through beWellnm for Small Business. Learn more about premium tax credits for small business.

Small employers with fewer than 50 employees are not required to provide insurance and are not subject to penalties for not offering a health plan. Employers with 50 or more full-time employees (including full-time-equivalent employees) are subject to a penalty if they don’t provide affordable health insurance. Employers of any size are not required to provide insurance for dependents or for part-time employees (generally, those who work fewer than 30 hours a week).

If you have 2-50 employees, there is no penalty. If you have 50 or more full-time employees and the coverage you offer meets minimum value requirements and is affordable, you aren’t subject to penalties if employees fail to enroll. Generally, a health plans meets standards if it pays at least 60% of the total cost of medical services for a standard population, and if its benefits include substantial coverage of inpatient hospital and physician services. Employees who are offered coverage that meets these requirements aren’t eligible for a premium tax credit on the individual Exchange.

For employers of 50 or more full-time-equivalent employees who do not meet the standards for providing health insurance, one of the following may apply :

$2,000 fine per employee (excluding the first 30 employees) per year for not offering coverage. This amount will be adjusted for inflation.

$3,000 fine per employee for each full-time employee receiving a tax credit when buying insurance on the individual Exchange, or the above penalty, whichever is less. This amount will be adjusted for inflation.

The four levels are bronze, silver, gold and platinum, also called metal levels. Bronze plans typically offer the lowest premiums, but generally have higher out-of-pocket costs, such as deductibles, copays, coinsurance and out-of-pocket maximums. Platinum plans generally have the highest premiums but lowest out-of-pocket costs. When choosing a plan, consider the needs of the employees in terms of paying for out-of-pocket costs as well as the premium costs. You should also consider the needs of the business or nonprofit organization, including finances and competition for employees.

No. The metal level has nothing to do with the quality of care provided by the plan. All plans offered through beWellnm for Small Business must provide coverage for essential health benefits and pre-existing conditions, as well as offer free preventive care. The metal level refers only to the premium costs and amount of coverage provided by the plan.

If you have 2-50 full-time employees, you are not required to offer coverage or pay a penalty. However, health insurance is an important benefit and can help you attract and keep valuable employees. Some employers increase wages to help offset the costs workers must pay to buy insurance on their own. However, any increase in wages is taxable income. Health insurance premiums are generally paid on a pre-tax basis.

If you have 2-50 or more full-time employees, you may face penalties for not offering affordable coverage. You should compare the cost of providing coverage against the cost of potential penalties.

For nonprofits and businesses with 50 or more full-time employees, there are rules about employer coverage affordability. Generally, if any of your employees qualifies for a premium subsidy through the individual marketplace, you may owe a penalty. A broker/agent can help you in determining if your coverage fits the affordability guidelines.

BeWellnm for Small Business (formerly called SHOP) is New Mexico’s health insurance marketplace for small businesses and small nonprofit organizations with 2 to 50 full-time-equivalent employees. Sponsored by the New Mexico Health Insurance Exchange, beWellnm for Small Business offers competitively priced health plans that cover essential health benefits as well as preventive care, with no pre-existing condition restrictions. BeWellnm for Small Business is the only place where employers may qualify for a tax credit by providing coverage to their employees.

Yes. Many companies prefer to work with an agent or broker, since the services of these experts are free to small business owners. Agents and brokers understand the New Mexico health insurance market and can help business owners choose the plan that best meets their needs. Find an agent or broker who can help you enroll in group health insurance.

The number of full-time-equivalent (FTE) employees is used to determine eligibility for small business premium tax credits and applicability of employer penalties for not offering coverage. The IRS uses a full-time-equivalent calculation, which adds the number of full-time and part-time FTEs. Part-time employee hours are translated into an “equivalent” number of full-time employees. For more information, check out the FTE calculator in our Small Business Toolkit.